The aim of the article is to present the development and application of a 3D-printed skull base model, which includes the internal carotid arteries, tumour and the optic nerve, to train neurosurgeons and ear, nose and throat (ENT) in performing the endonasal endoscopic approach (EEA). This procedure is challenging due to the proximity of critical structures such as nerves, blood vessels and brain. The 3D model was generated using magnetic resonance imaging (MRI) and computed tomography (CT) scans, which provided detailed anatomical data. These scans were processed with 3D reconstruction software to accurately replicate the key areas, including the tumour and surrounding structures. Neurosurgery and ENT consultants and residents, practised the EEA using these printed models. After completing the procedures, participants filled out a questionnaire to evaluate the realism and reliability of the model by applying a statistical analysis appropriate to the study. The participants reported that the 3D-printed models provided a highly realistic simulation of the anatomical structures involved in the EEA. The model was deemed effective in replicating the key areas of interest, allowing them to safely practise the procedure in a controlled environment. Our results show that in two days approximately and for less than 10€, the surgeon may have the opportunity to train the surgery after establishing the printing parameters. A strong positive correlation was found among these variables (p < 0.01), suggesting that those who found the model useful also perceived a greater clinical applicability and believed that the 3D-printed model could help improve their surgical skills. The study demonstrates that 3D-printed models based on MRI and CT scans offer a reliable and realistic method for surgical training. These models provide an essential tool for practising complex procedures, such as the EEA, improving the safety and effectiveness of surgical training and potentially enhancing patient outcomes.
Radiological training is often underrepresented in medical education, despite its essential role in clinical practice. Innovations like 3D printing offer detailed anatomical models that enhance understanding. In kidney cancer management, imaging and tumor complexity scores are crucial. This study evaluated whether three-dimensional (3D) kidney models could improve medical students’ anatomical and spatial understanding of renal tumors, as assessed through CT-based complexity scoring. Three kidney tumor cases of varying complexity were selected. CT scans were segmented using Synapse 3D® to create models printed with high-resolution, multi-material technology (Stratasys J750®). Twenty-three fifth-year medical students were randomized into three groups: CT-only, CT + 3D virtual model (3DV), and CT + 3D-printed model (3DP). Each group interpreted the same anonymized CT scans and completed questionnaires assessing complexity scores and anatomical understanding. Accuracy and time efficiency were compared across groups. The 3DV and 3DP groups showed significantly greater accuracy in completing complexity scores (91
Stent failure in the peripheral arterial system remains a major clinical challenge due to high mechanical demands caused by limb movement. Unlike coronary arteries, below-the-knee vessels are exposed to continuous flexion, torsion and axial movement, increasing the risk of structural failure, stent collapse, fracture or migration. Due to their tuneable mechanical properties, polymeric stents enabled by advanced additive manufacturing emerge as a potential candidate to overcome the current limitations of metallic stents. This study examines whether polymeric stents made with the ST3DT process and reinforced photoresin can endure all phases of manufacturing and deployment — including printing, rinsing, post-curing, crimping, and sterilisation — while retaining suitable mechanical properties for vascular use. Nine different stent geometries were produced by varying strut angle and printing feedrate, thus achieving different strut profiles. Curing was assessed by DSC and FTIR and mechanical properties were evaluated with radial and axial compressions tests, three-point bending and crimping. Finally, a CT-scan was performed to analyse radiopacity of reinforced polymeric stents with promising results. The findings indicated that although decreasing strut angles and reducing printing speeds led to better mechanical performance, they also made the crimping process more challenging. Two stents were selected with a balance of all criteria to continue the development of novel photopolymerised polymeric stents.
Given the established and reproducible benefit of 3D-printed models in complex congenital heart disease (CHD) surgical planning, the focus has shifted from validating their utility to refining anatomical fidelity through enhanced imaging integration. The purpose of this study is to evaluate the perceived clinical utility of multimodality fusion 3D-printed cardiac models and to determine whether inclusion of valve structures confers incremental benefit over conventional single-modality 3D models in enhancing anatomical understanding and preoperative surgical planning among pediatric cardiac surgeons and imaging cardiologists in complex CHD. In this feasibility study, multimodality fusion 3D models were successfully generated by integrating cross-sectional imaging (cardiac computed tomography and magnetic resonance) with 3D echocardiographic datasets to reproduce atrioventricular valve apparatus and subvalvular structures in 10 pediatric patients with complex CHD. Ten faculty members (7 pediatric cardiologists with advanced imaging expertise and 3 pediatric cardiothoracic surgeons) evaluated 10 patient-specific models using a structured Likert questionnaire. Surgeons assigned significantly higher ratings than imagers for anatomical understanding (median 5 vs 4; p = 0.002) and surgical planning (p < 0.001). Participants agreed that multimodality models are most valuable in complex congenital heart disease, particularly in cases requiring ventricular septal defect patching or intraventricular baffle repair involving the subvalvular apparatus. Multimodality imaging fusion for 3D printing is technically feasible and produces high-quality models with strong intraoperative correlation. Incorporation of atrioventricular valve anatomy provides meaningful incremental benefit—particularly for surgeons—enhancing operative planning in complex CHD.
Point-of-care (POC) three-dimensional (3D) printing of medical devices presents a paradigm shift in personalized medicine, yet clinical implementation of polyetheretherketone (PEEK) implants remains limited by regulatory, technical, and quality assurance challenges. Traditional external manufacturing timelines of 2–6 weeks constrain immediate reconstruction capabilities, particularly in trauma and oncologic cases requiring rapid intervention. Structured frameworks enabling MDR-compliant hospital-based production of implantable devices remain limited in the literature. We implemented a comprehensive European Union Medical Device Regulation (EU MDR) 2017/745 Article 5(5)-compliant POC manufacturing framework incorporating an electronic quality management system aligned with ISO 13,485, a manufacturing execution system enabling end-to-end device traceability, risk management, process validation, biocompatibility evaluation, and integrated post-market surveillance. Medical-grade PEEK was processed using validated high-temperature specialised material extrusion 3D printers. Representative clinical applications of the EU MDR-compliant point-of-care manufacturing framework are illustrated in two anatomical contexts: (1) a POC 3D-printed PEEK cranial implant and (2) a POC 3D-printed PEEK facial implant. Manufacturing turnaround from image acquisition to sterile delivery was operationally achievable within 3–5 days. The patient-matched implants demonstrated accurate anatomical fit without intraoperative modification, with no major device-related complications observed. The framework has supported the production of over 40 + POC 3D-printed PEEK implants at the index institution and has since been adopted at multiple European centres, demonstrating transferability beyond the index case series. This work describes a validated EU MDR Article 5(5)-compliant framework for hospital-based production of patient-matched 3D-printed PEEK implants, demonstrated across cranial and facial reconstruction. Early clinical results support safety and feasibility, with end-to-end manufacturing achievable within a week, enabling flexible surgical planning. The framework provides a replicable pathway for regulated POC implant production, with multi-centre adoption and long-term outcome surveillance as critical next steps.
Traditional methods for producing custom-made orthoses are often time-consuming, labor-intensive, and reliant on manual processes, which limit both scalability and the degree of individualization. The development of 3D scanning technologies, computer-aided design (CAD), and additive manufacturing offers a promising alternative enabling patient-specific solutions with greater precision, speed, and efficiency. This study aimed to create an algorithm for automating the design process of personalized knee orthoses based on 3D scanning and intended for 3D printing production. A parametric modeling workflow was developed in the Rhino environment using the Grasshopper plug-in to streamline personalized knee orthoses creation. The process began with acquiring high-quality 3D scans using Structure Sensor Mark II scanner mounted on an iPad with 3DsizeMe software. The parametric algorithm was transformed into an autonomous Rhino plug-in using C# language and RhinoCommon API. As part of Post-Market Clinical Follow-up (PMCF), three participants with knee joint disorders used orthoses for one month. Assessment used a 5-point scale (1 = poor, 5 = excellent). Personalized orthoses were manufactured using powder-bed fusion technology with PA11 CF nylon powder reinforced with carbon fibers. Design time was reduced from approximately 8 h to 10,3 ± 1,4 min. In Grasshopper prototype phase, average design time was 26,7 ± 4,5 min. Following the implementation of the Rhino plug-in, the design time was further reduced to approximately 10 min. The tool was shown to meet user requirements and fulfill its intended purpose. All three PMCF participants rated orthoses positively, reporting high comfort, effective stabilization, increased physical activity, and overall satisfaction with functionality and appearance. Participants P1 and P2 noted a large increase in physical activity, with P1 indicating pain reduction that increased mobility. This study demonstrates that the combined use of Rhino and Grasshopper provides an effective platform for parametric design of personalized knee orthoses based on patient-specific 3D scans. The workflow reduced design time to approximately 10,3 ± 1,4 min, highlighting potential for routine clinical applications. This reduction is economically significant, lowering labor costs and implementation thresholds for personalized orthotic solutions in clinical practice.
Abstract Background This study investigates a 3D printed, noninvasive headrest that was designed for use in orbital and skull base surgeries and compares the stability of this innovative headrest to conventional head immobilization devices using accelerometer-based measurements. Methods A 3D model of a headrest was developed using two plastic materials: polyethylene terephthalate glycol (PETG) and thermoplastic polyurethane (TPU). Stability, in g-force, was measured for these headrests, Gel Head Donut Adult Blue Diamond®, and a no headrest condition. A non-embalmed cadaver’s head was placed in each headrest condition and subjected to controlled oscillations using Bellco Glass’ Orbital Shaker. Acceleration data were recorded over a 3-second interval. Results The average acceleration, measured in g-force (g), over 3 s for each headrest configuration was: (1) no headrest: 0.068116 g ± 0.058498, (2) Gel Donut head immobilizer: 0.064223 g ± 0.027463, (3) PETG headrest: 0.053331 g ± 0.037782, and (4) TPU headrest: 0.056254 g ± 0.032200. The PETG headrest showed a 21.71% improvement over no headrest and a 16.96% improvement over the gel donut headrest in maintaining head stability. And the TPU headrest showed a 17.41% improvement over no headrest and a 12.41% improvement over the gel donut headrest in maintaining head stability. Conclusions The PETG and TPU headrest provided greater stability compared to the commonly used Gel Head Donut headrest and in the absence of a headrest. This study suggests that the design of this headrest offers a potential noninvasive head stability device, regardless of material composition, that may improve the safety and efficacy of orbital and skull base surgery.
This study assessed two different 3D-printed endovascular simulation models and a digital simulator for training of endovascular interventions. Thirty-two vascular surgeons and radiologists completed interventions using two transparent 3D-printed models—a flexible model, printed with Stereolithography (SLA), and a stiff model using Fused Deposition Modelling (FDM) technology —as well as a digital simulator. A standardized questionnaire assessed the models’ perceived face and construct validity as well as their concurrent validity. Additionally, the impact of model material (flexible vs. stiff) on perceived fidelity and utility were evaluated. All participants completed the three interventions successfully. There was an even distribution of sex (16 males and females) and experience among the participants. The flexible 3D-printed model demonstrated significantly higher face and construct validity scores compared to the stiff model and the digital simulator (p < 0.001). No significant differences were observed between the digital and stiff models for face and construct validity (p = 1.0, p = 0.38). Regarding concurrent validity, there was a significant preference for the 3D-printed models (72
Veterinary anatomy education increasingly demands innovative strategies to enhance spatial understanding and student engagement. Mixed augmented reality (MAR) has emerged as a promising tool, integrating virtual anatomical models into real environments. This study aimed to describe the pratical implemention and evaluate the pedagogical benefits of a MAR-based holographic platform for teaching selected osteological structures in veterinary anatomy. A Veterinary Anatomy Holographic Platform (VAHP) was developed using 3D digitized bone models integrated into a mixed reality display. Anatomical models of equine skull, scapula, femur, and the canine axis were processed using photogrammetry and 3D Slicer, then rendered with Unreal Engine 4.27. The platform was implemented during regular classrom session with 80 veterinary students. Learners interacted with the holographic models and subsequently completed a four-question proficiency test. Results were compared to a control activity using real anatomical specimens and analyzed using Z-tests for two proportions. Significant improvements in permfomance were observed in three of the four test questions after using the VAHP (p < 0.05), particularly for structure requiring complex spatial reasoning. No statistical improvement was found for one question (p = 0.058). The holographic session were well accepted by students and promoted engagement in the classroom. This proof-of-concept study showed that the VAHP, delivered through a mixed reality headset, can enhance anatomical learning and engagement in osteology. Broader and longer-term studies are needed to confirm its impact and guide curriculum integration.
BackgroundTechnological advancements have made 3D printing more accessible and affordable for both individuals and institutions. Despite significant efforts by the International Medical Device Regulators Forum to standardize 3D printing regulations for medical use, challenges remain. We conducted a survey to gather insights from physician end-users on their opinions regarding the regulation of 3D printing in medicine. Additionally, since FDA guidance is often adopted internationally, this survey aimed to capture the demographics of physician end-users globally and provide a snapshot of the current use of 3D printing in clinical practice and research.MethodsAfter developing and validating a 26-question survey, we emailed it to the corresponding authors of all PubMed-indexed publications on 3D printing in medicine. Participants received an introductory email explaining the survey's purpose and an invitation to participate. Only responses from participants who declared themselves to be physicians were accepted. The survey was open for responses from April 5th to May 3rd, 2022, with weekly reminders sent until the response period closed. Responses with at least 80% survey completion were accepted for analysis.ResultsOut of 951 surveys sent, we received 114 responses (11.9%) with an average completion rate of 89%. Most respondents were from Europe (35.5%) and North America (30.9%), followed by Australia and New Zealand (9.1%). The majority were affiliated with academic institutions (83.9%) and were primarily surgeons (49.1%). The most common application of 3D printing was surgical planning (74.1%), followed by medical education (61.6%). Nearly 50% of respondents used open-source segmentation software without FDA approval. Most had access to an onsite printer (82.2%) and specially trained staff to assist with segmentation (53.4%).ConclusionsThe integration of 3D printing technologies into clinical practice will continue to grow. This paper presents the largest survey of physicians practicing 3D printing to date. Given the underrepresentation of this key demographic within regulatory bodies, the opinions and positions of physician respondents reported here should be considered in the development and application of new guidelines and regulations in the field.
Three-dimensional (3D) ultrasound provides more intuitive, detailed, and comprehensive diagnostic information. The primary objective of this study was to develop affordable, lightweight, and wide-field 3D ultrasound probes which is a critical challenge for expanding the accessibility and utility of this technology. We describe an affordable freehand scanning 3D ultrasound reconstruction system. The system utilizes a QR code film attached to the skin surface for positioning. During each ultrasound scan, a lightweight camera fixed on the probe records the QR codes within the scanning area. Based on QR code features, a skin map is constructed, and ultrasound images and film image information are preprocessed. The calibration relationship between the ultrasound probe and camera field of view is determined. Finally, comprehensive algorithms such as ORB-SLAM positioning are used for three-dimensional image reconstruction. Through hand-scanning tests, the results show that the scanning speed is 15 mm/s, and when the image acquisition frame rates are 10 Fps/s, 20 Fps/s, and 30 Fps/s, the maximum cumulative error of ORB-SLAM algorithm positioning does not exceed 2
In the 2019/2020 winter semester, the University of Augsburg’s Faculty of Medicine introduced a competence-oriented model degree program with a spiral curriculum integrating theory and practice. A key feature, the clinical longitudinal course, emphasizes practical skills such as skin examination. Existing training materials for punch biopsies, e.g., foam models and fruit, have proven insufficient. This project aimed to create a realistic, cost-effective, reusable three-dimensional (3D) skin model to improve the teaching of punch biopsy and suturing techniques. The 3D skin model was developed in a multistage process. It began with a 3D scan created via a handheld 3D scanner and refined in 3D modeling software. A fused deposition modeling (FDM) printer produced negative molds that were filled with silicone, resulting in a realistic model. After several iterations, a design was achieved that successfully simulated the tactile and functional aspects of punch biopsy and skin suturing. Student feedback was collected through an anonymous online questionnaire assessing perceived realism, usefulness for practicing punch biopsies and suturing, and impact on their confidence. The silicone-based skin simulator debuted in the 2023–2024 winter semester’s ‘examination of the skin’ course. A total of 82 students participated in the course, of whom 58 completed the evaluation questionnaire. The students used the model to perform punch biopsies and suturing, reporting that its material properties allowed these procedures to be practiced under course conditions. With a low production cost (of 0.62 € per model) compared to commercial models, it is a cost-efficient alternative to previous materials. The students provided positive feedback, reporting increased confidence in performing these procedures on humans for the first time. The 3D training model is an important advancement in introducing 3D technologies in practical training, providing realistic, cost-effective practice for punch biopsy and suturing. Its successful integration into the curriculum highlights its potential for broader applications in medical education. The evaluation indicated that the model provided realistic skin properties and proved effective for practicing punch biopsies and suturing, thus addressing the limitations of traditional training materials.
Atlantoaxial subluxation (AAS) is a severe instability of the craniovertebral junction that may cause progressive spinal cord compression and neurological impairment. Achieving complete reduction remains challenging when anterior inclination deformity of the atlas limits posterior traction. This study introduces a novel titanium alloy expandable wedge-shaped spacer designed to correct the anterior inclination of the atlantoaxial joint (AAJ) and facilitate controlled distraction and reduction. The implant integrates a two-stage expansion mechanism that enables sequential anterior elevation and fixation stability. To overcome the scarcity of cadaveric specimens, a patient-specific 3D-printed C1–C2 model was reconstructed from clinical CT data to replicate pathological morphology, simulate ligament behavior, and provide a reproducible biomechanical testing platform. Static and fatigue compression tests, performed according to ASTM F2077 and ISO 23089-2, demonstrated superior load-bearing strength (6725 ± 123 N) and long-term durability over 5 million cycles at 1650 N, with an expansion torque of only 52.56 ± 7.54 N·mm. Reduction experiments using the 3D-printed platform showed that the spacer decreased the required traction force by approximately 70
Effective procedural training is crucial for emergency interventions such as percutaneous cricothyrotomy (PC). This study evaluated simulation-based training of PC by comparing two simulators, a commercially available conventional simulator (CSIM) and an innovative 3D-printed simulator (3DSIM), and assessed their impact on procedural performance and subjective safety perceptions using two different PC kits: Quicktrach II (direct puncture method) and Surgicric III (Seldinger technique). Forty-four participants underwent standardized theoretical training and were randomized into two groups: Group A initially trained with CSIM and Group B with 3DSIM. In both groups, procedural performance was evaluated immediately after each simulation session on porcine trachea models by two blinded assessors. Outcomes included procedural time, standardized performance scores, and subjective safety ratings. Participant evaluations of educational benefit and simulator realism were also recorded. Training effectiveness was reassessed in a second session using a crossover design, allowing direct comparison of the two simulators and kits. Procedural performance improved significantly after repeated training, with no significant differences between CSIM and 3DSIM regarding procedural times (p = 0.98) or accuracy scores (p = 0.99). Both PC kits showed significantly reduced procedural times (Quicktrach II: 42 ± 46 to 19 ± 7 s, p < 0.01; Surgicric III: 119 ± 73 to 91 ± 51 s, p = 0.03). Accuracy improved significantly only for Surgicric III (95 ± 10
The objective of the present work is to assess the intraoperative utility, operative benefits, and limitations of mixed reality (MR) by reviewing the entire literature across surgical disciplines. A focused literature search was conducted on December 12, 2024, across major databases, including PubMed, EMBASE, and Cochrane. The review included original studies that examined intraoperative MR applications in human surgical procedures with a technology readiness level (TRL) of 6 or higher. Exclusion criteria ruled out studies involving augmented reality (AR) or virtual reality (VR) alone, as well as non-English literature and conference proceedings. Selected studies were categorized based on their application in surgical navigation, image guidance, and image reference. A total of 41 studies met the inclusion criteria, covering 760 patients across multiple surgical disciplines. Three primary MR applications were identified: (1) Surgical navigation (MR-SN): used for real-time instrument tracking and trajectory definition in procedures such as spinal surgery, neurosurgery, and maxillofacial surgery; (2) Image guidance (MR-IG): employed for visual overlay of 3D models onto anatomical landmarks without instrument tracking, primarily in visceral, plastic, and reconstructive surgery; (3) Image reference (MR-IR): utilized as a static 3D reference model adjacent to the surgical field in various disciplines, including ophthalmology and interventional radiology. The Microsoft HoloLens and HoloLens 2 were the most used head-mounted displays (HMDs), with additional applications of Magic Leap 2 and xvision Spine System. MR demonstrated improvements in surgical precision, efficiency, and visualization. However, limitations such as ergonomic discomfort, latency, narrow field of view, and challenges in anatomical superimposition were noted. Mixed reality is an emerging technology with the potential to enhance intraoperative visualization, guidance, and navigation across multiple surgical disciplines. Several challenges limit its widespread adoption. Further clinical trials and regulatory approvals are required to establish MR as a standard tool in surgical practice.
BACKGROUND: 3D printing is increasingly utilized in medical education, providing a hands-on approach to anatomical learning, surgical planning, and interdisciplinary collaboration. Despite growing interest, standardized curricula incorporating 3D printing into medical education are lacking. METHODS: A multidisciplinary team of medical educators, engineers, and students developed three distinct curricular models to integrate 3D printing into undergraduate medical education. These models include (1) integration into anatomy coursework, (2) a fourth-year clerkship elective, and (3) a pre-clerkship elective. The outline for each curriculum was designed to be adaptable across institutions, emphasizing hands-on learning, imaging segmentation, basic elements of computer-aided design (CAD), and 3D printing applications in clinical care. RESULTS: The proposed curricula outlined provide structured pathways for incorporating 3D printing into medical education, enhancing student engagement and comprehension of complex anatomical structures. By integrating 3D printing into anatomy courses, clerkships, and elective rotations, students gain critical skills applicable to future clinical practice. The curricular models vary in scope and resource requirements, offering flexibility for adoption across medical schools. CONCLUSIONS: Standardizing 3D printing curricula in medical education enhances anatomical understanding, promote interdisciplinary collaboration, and prepare students for future applications of this technology in clinical practice. Our framework serves as a guide for institutions seeking to implement 3D printing curricula, fostering innovation and hands-on learning opportunities for medical trainees. TRIAL REGISTRATION: Not applicable. CLINICAL TRIAL NUMBER: Not applicable.
In medical education, the BOPPPS (Bridge-In, Objective, Preassessment, Participatory Learning, Post assessment, Summary) teaching model has gained traction for fostering student-centered learning, yet its efficacy in orthopedic education, particularly when integrated with 3D printing technology, remains understudied. This study aimed to evaluate the impact of combining the BOPPPS model with 3D printing on learning outcomes, student satisfaction, and clinical skill development in mainland China’s orthopedic curriculum. A single-center, prospective observational study was conducted with 68 fifth-year clinical medical students at Tongji Medical College, randomized into a control group (n = 34, traditional lecture-based teaching) and an intervention group (n = 34, BOPPPS model + 3D printing). The intervention incorporated patient-specific 3D-printed pelvic fracture models into BOPPPS-structured sessions, focusing on participatory learning activities like fracture classification and surgical planning. Primary outcomes included theoretical knowledge (100-point exam), clinical practice ability (100-point skills assessment), self-ability evaluation (15-item questionnaire), student satisfaction (15-item Likert-scale survey), and learning quality indicators (input, process, outcome evaluations). The intervention group outperformed the control group in all primary outcomes. Theoretical knowledge scores were significantly higher in the intervention group (83.28 ± 10.74 vs. 68.94 ± 11.08, p < 0.001), as were clinical practice ability scores (82.64 ± 8.67 vs. 69.36 ± 10.93, p = 0.008). Self-ability evaluations showed a 18-percentage-point increase in “excellent” ratings (41.18
Non-invasive ventilation is commonly used to support critically ill children with acute respiratory failure in the pediatric intensive care unit. However, non-invasive ventilation treatment is often hindered by poorly fitting masks due to limited commercially available options. Personalized non-invasive ventilation masks are a promising solution, yet research on the feasibility of their production in real-world clinical settings, particularly regarding facial data acquisition, remains limited. This study aims to assess the feasibility of using a handheld 3D scanner for facial data acquisition in critically ill children admitted to the pediatric intensive care unit. In this single-center pediatric intensive care unit feasibility study, facial 3D data was obtained from children (age 0–18 years) receiving non-invasive respiratory support for acute respiratory failure, using a handheld 3D scanner. Feasibility outcomes included the scan process and quality factors. Scan quality was evaluated based on scan errors and removed movement frames. Facial 3D data acquisition was defined as feasible if > 80
To determine the reusability and robustness of three 3D-printing materials for anatomical vessels by evaluating their contrast agent uptake characteristics throughout different timeframes. The tested samples were 3D-printed cylindrical samples that have the same diameter and wall thickness as a healthy adult aorta. Three different materials of varying degrees of Shore hardness were used to print these samples on a Stratasys J850 Prime PolyJet 3D printer (VeroClear, Agilus, and an Agilus/VeroClear mixture). Each sample was filled with one of three contrast agent dilutions or a control solution. Samples remained filled with their respective solution for one week, one day, or one hour. Computed tomography (CT) and magnetic resonance (MR) images were taken of all 54 samples. The CT and MR images were evaluated to determine the diameters of the samples, as well as the radiodensity/signal intensity of the samples. An Intraclass Correlation Coefficient (ICC) was calculated to determine the degree of measurement variation between the investigators. Sample mass increase was determined by weighing samples before and after exposure to the solutions. A generalized linear mixed model (GLMM) was used to evaluate the contrast agent uptake behavior of the materials based on CT and MR imaging data. A small relative mass increase in the 3D-printed materials was noted: VeroClear showed mass increases of between 1.1
BACKGROUND:Total ear reconstruction in patients with microtia remains a complex aesthetic and technical challenge. Accurate positioning and customization of porous polyethylene implants are critical, yet current methods often rely on manual planning and intraoperative adjustments. METHODS:At Schneider Children's Medical Center, high-resolution 3D facial scans or CT data were used to design patient-specific preoperative jigs and a custom single-piece implant. The jig guided precise ear positioning using facial landmarks and incorporated vascular mapping via CTA to identify branches of the superficial temporal artery. BioMed Elastic 50A Resin was used for jig printing, and the implant was tailored to patient age and anticipated ear growth. RESULTS:The technique enabled accurate ear alignment with the contralateral ear, minimized intraoperative adjustments, and eliminated the need for implant assembly. The integration of vascular mapping into the jig improved flap design and may reduce complications. Compared to traditional methods, this 3D-guided approach demonstrated improved positioning accuracy, reduced operative time, and enhanced aesthetic predictability. CONCLUSIONS:This 3D-guided technique streamlines ear reconstruction and offers an efficient and reproducible solution that improves surgical planning and outcomes in patients with microtia.
